This invention relates to an improved surgical pillow especially adapted to support, cushion and position a patient while in a prone position on an operating table during rectal surgery.
At the present time, positioning of a patient for rectal surgery on a conventional operating table is most usually accomplished by making up rolls of blankets, towels or other similar items which are then placed along opposite sides of the patient""s torso. That technique has many disadvantages including the tendency for the rolled support to shift and tend to be displaced from the original patient supporting locations thereof, and the fact that the rolls do not provide optimum patient cushioning and positioning. Furthermore, it is difficult to arrange the blanket or towel rolls in this position such that the patient""s arms can be placed comfortably hanging over the edges of the operating table. Equally as significant, although support is provided by the rolls, blanket or towels for the patient""s torso, the patient is still lying flat on the table in a prone positions such that pressure is inherently applied to the central part of the patient""s body. The result is a tendency for the compressive forces on the patient""s torso to impede veinous blood return to the patient""s heart.
Efforts to solve the problem of providing comfortable and effective support and positioning of a patient in a prone position during rectal surgery have not found widespread acceptance and universal usage in part because of the complexity and cost of prior devices, the inability of the supporting devices to adequately accommodate patients of different sizes and weights, and the inordinate setup and adjustment time encountered with certain units.
U.S. Pat. No. 6,076,525 discloses a frame for supporting a patient in a prone position for surgery which includes a frame having longitudinal and lateral beams which support upright posts having pads on the upper extremities thereof. The posts are adjustable laterally and longitudinally of the beams for patients of different sizes. The frame assembly of the ""525 patent not only requires extensive adjustment, but is also not intended to support a patient during rectal surgery, but instead is specifically designed to maintain a patient""s back in an orthopedically preferred position for spinal surgery.
Similarly, U.S. Pat. No. 5,239,716 relates to a surgical spining positioning frame made up a multiplicity of parts for lateral, longitudinal and pivotal adjustment said to allow optimal patient positioning. A powered actuator is provided which serves to actuate flexible strips and pads to position the patient so that the curvature of the patient""s spine may be adjusted to assure maximum lumbar access.
Another spinal surgery support is illustrated and described in U.S. Pat. No. 4,840,362 in which comprises a kit of resilient blocks interconnected by hoop and loop fasteners for securing the various blocks in desired positions. The blocks are shaped and dimensioned for different patient sizes and different curvatures of the patient""s spine. The kit includes a base block, a U-shaped block, inside and outside filler blocks, face and chest blocks, and a pair each of flexion, lordosis, or neutral blocks. The nature of the surgical procedure and the size and shape of the patient are said to determine the size and identity of the blocks to be used.
U.S. Pat. No. 2,764,150 concerns a convex spinal frame in which the curvature of a main support panel which carries opposed rolls held in place by fastening belts or the like. The curvature of the main panel may be adjusted as desired by adjustment of a hand operated screw connected to links joined to respective opposite ends of the support panel.
U.S. Pat. No. 4,579,111 relates to a lumbar lamenectomy pad made up of two elongated two elongated pyramidally configured bolsters carried by a rectangular base cushion and associated with a headrest or pillow. The two side by side bolsters present a V-shaped cavity therebetween for receiving the torso of a patient. Arm restraints are provided on opposite sides of the triangularly configured bolsters.
The spinal surgery chest bolster assembly of U.S. Pat. No. 4,908,892 is made up of a chest support bolster which is used in conjunction with a separate triangular spinal surgery frame. The support bolster consists of a trapezoidal pillow having a central slot for receiving the patient""s head and providing shoulder support.
An iliac support frame for a patient during back surgery as disclosed in U.S. Pat. No. 4,923,187 has two horizontally spaced, hemispherical pillows which have curved upper surfaces. The semi-circular upper surfaces of the opposed patient supporting pillows are said to better maintain a patient""s vertebrae in desired curved, spaced relationship for X-ray examination. A somewhat similar spinal surgery frame having spaced curved upper surface supports is illustrated in U.S. Pat. No. 5,584,302.
A surgical pillow is illustrated in U.S. Pat. No. Des. 438,046, having a central planar portion with two elongated, spaced blocks positioned on the central portion. The construction of the pillow is unknown and the manner in which a patient is supported by the pillow cannot be discerned from the patent drawings. A pillow having a channel formed centrally therethrough is also illustrated in U.S. Pat. No. Des. 397,270.
An improved surgical pillow is provided for supporting and cushioning patients of different sizes and weights while the patient is in a prone position on an operating table during rectal surgery. The pillow comprises an elongated, self-sustaining body unit of compressible material having shape return memory. The body unit is provided with an indented upper face defined by a longitudinally extending, centrally located channel, and chamfered downwardly inclined surfaces on opposite sides of the central channel.
The pillow is designed to be placed on the flat surface of a conventional operating table used for rectal surgery in which the patient""s torso rests in a prone position on the table, while that person""s legs extend beyond the table and are supported by an L-shaped accessory component of the table. The chamfered inclined surfaces engage, cushion and cradle the patient""s torso and maintain the patient in a centrally disposed position on the operating table during the operation. In addition, the pillow provides reproduceable positioning of different patients with variable body habitus. Patients are more secure on the operating table with less chance of fall. Jackknife positioning of a patient on the surgery table is avoided. Most importantly, improved veinous blood return through the central channel of the pillow is assured, thereby lessening risk of hypotension during the surgical procedure.
In particular, the body unit of the surgical pillow includes an elongated, generally rectangular base section which supports a pair of elongated, parallel, spaced, transversely polygonal torso support sections extending along the length of the base unit. The polygonal sections have inwardly facing, directly opposed chamfered surfaces which extend downwardly from the top walls of corresponding sections and that merge with respective upright, horizontally spaced inner walls of the sections which cooperate with the top surface of the base section to define the central channel through the body unit. End portions of the base section as well as corresponding ends of the polygonal sections are inclined relatively to define upright, outwardly diverging inclined surfaces on opposite sides of the base section in disposition to receive the upper ends of the patient""s arms when the patient is cradled by the pillow.
The foam body unit is preferably provided with a removeable cover which generally conforms to the outer surface configuration of the pillow, thereby permitting the cover to be periodically sanitized independent of the body unit, and to be replaced if desired.